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. 2023 Sep;75(3):2657-2661.
doi: 10.1007/s12070-023-03613-8. Epub 2023 Mar 3.

Management of Parastomal Recurrence Following Total Laryngectomy

Jonathan Fussey  1 , Akshay Kudpaje  2 , Jonathan Clark  3   4   5 , Carsten E Palme  3
Affiliations

Management of Parastomal Recurrence Following Total Laryngectomy

Jonathan Fussey et al. Indian J Otolaryngol Head Neck Surg. 2023 Sep.

Abstract

Parastomal recurrence occurs in around 5% of patients undergoing total laryngectomy for laryngeal squamous cell carcinoma. It carries a poor prognosis which has changed little over the last 50 years, and poses a significant challenge to the head and neck surgeon. At present, surgical excision offers the only realistic chance of cure, although patients must be selected carefully following thorough work-up and in-depth multidisciplinary team discussion. This article provides a review of the literature on the management of parastomal recurrence following total laryngectomy.

Keywords: Carcinoma; Laryngectomy; Local; Mediastinal neoplasms; Neoplasm recurrence; Squamous cell.

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Conflict of interest statement

Conflict of interestsNo author has any competing interest to declare.

Figures

Fig. 1
Fig. 1
Sisson classification of parastomal recurrence: 1—discrete nodule in the superior aspect of the stoma; 2—oesophageal involvement but limited to the superior aspect of the stoma; 3—originating inferiorly, usually with direct involvement of the mediastinum; 4—Inferior and lateral extension under one or both clavicles
Fig. 2
Fig. 2
Axial contrast-enhanced CT and fused axial FDG PETCT showing type III parastomal recurrence inferior to stoma but not involving oesophagus
Fig. 3
Fig. 3
Surgical management of Sisson type III parastomal recurrence, demonstrating pre-operative marking and en-bloc excision of tumour with surrounding skin and inferior tracheostome along with partial manubriectomy after identifying ipsilateral common carotid artery and innominate artery, and anterolateral thigh free flap reconstruction. The appearance 2 months post-operatively is also shown
See this image and copyright information in PMC

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